Gawande points to a study recognizing a group of people that disproportionately uses medical resources:

‘His calculations revealed that just one per cent of the hundred thousand people who made use of Camden’s medical facilities accounted for thirty per cent of its costs.’

And a potential solution for these ‘super-utilizers:’

‘In addition to physicians and nurses, the Center employs eight full-time “health coaches,” who help patients manage their health.’

‘Health-coaches’ frightens me a bit. I’m still worried about politicizing the issue further; entrenching health-care as a right, which will also make it a political football (soon to be third-rail), potentially unionize it, open it to many more forms abuse and fraud (and diverging political and healh-insurance goals).

A reader sent in two quotes from Henry Hazlitt, libertarian economist:

“The art of economics consists in looking not merely at the immediate but at the longer effects of any act or policy; it consists in tracing the consequences of that policy not merely for one group but for all groups.”

and

“The first requisite of a sound monetary system is that it put the least possible power over the quantity or quality of money in the hands of the politicians.”

7:43 long. The title is ‘George Will on rationality, principles, and reality.’

The same reader who sent the link wonders if there are some people who pursue the argument of free market economics with a zealous rationalism (not necessarily materialistic, but rationalist)..and if there isn’t there some Empiricist/philosophcial/political tradition relatively free of this metaphysical debate?

I’m not sure. At the very end, Will states:

“It’s not the question of contradictions being true, but the questions of contradictions being real”

From a Leo Strauss quote on Edmund Burke earlier posted (Strauss thought Burke too, perhaps, was succumbing to his definition of historicism):

“What ever might have to be said about the propriety of Burke’s usage, it is here sufficient to note that, in judging the political leaders whom he opposed in the two most important actions of his life, he [sic Burke] traced their lack of prudence less to passion than to the intrusion of the spirit of theory into the field of politics.”

‘Since 1945 Western governments have, for the most part, embodied both democracy and constitutional liberalism. Thus it is difficult to imagine the two apart, in the form of either illiberal democracy or liberal autocracy. In fact both have existed in the past and persist in the present. Until the twentieth century, most countries in Western Europe were liberal autocracies or, at best, semi-democracies.’

‘According to my observations (for which I claim nothing by that they are all I have to go by) inaction is better than wrong action or premature right action, and effective right action can only follow right thinking. “If a great change is to take place,” said Edmund Burke, in his last words on the French Revolution, “the minds of men will be fitted to it.”‘

and:

‘It is a primary instinct of human nature to satisfy one’s needs and desires with the least possible exertion; everyone tends by instinctive preference to use the political means rather than the economic means, if he can do so.’

Albert Jay Nock, a strange animal: Philosophical anarchist…but one whose anti-statism (the State maintains a monopoly on crime) is such that he ends up in a fairly conservative position.

“One root cause of the ethnic strife is the retreat of the state; Karachi’s local government has simply failed to keep up with the city’s expanding population. It has refused or been unable to provide basic physical infrastructure and services, such as housing, water, and electricity, or economic opportunities and resources to the majority of residents. Instead, the urban poor have relied on ethnic-based sector entrepreneurs to provide these essential services. This informality in social and economic relations has allowed ethnic rivalries to fester.”

“The following is a neat little experiment whose result may be counterintuitive to some of those who embrace the “all bodies fall the same way inside earth’s gravity” ‘doctrine’ without quite understanding it.”

Brooks places the book in a long line of “brilliant books,” which by his definition would be:

“…the sort of book written by a big thinker who comes to capture the American spirit while armed only with his own brilliance.”

Or more precisely: intellectually ambitious if not pretentious, and doomed to failure in dealing with the scope of its subject. Only Alexis De Tocqueville perhaps reached the bar he set for himself in Brooks’ opinion. This hasn’t stopped others from trying.

There’s some run-of-the-mill left-bashing here, as Brooks is casting Schama’s in the mold of Bernhard Henri-Levy’s ‘American Vertigo’ (review here at the NY Mag Of Books, the “anti-anti”American).

Also:

“In the 1980s, Jean Baudrillard came armed with Theory and set the modern standard by dropping puerile paradoxes from coast to coast: “Americans believe in facts, but not in facticity.” Brilliant! “Here in the most conformist society the dimensions are immoral. It is this immorality that makes distance light and the journey infinite, that cleanses the muscles of their tiredness.” Brilliant!.”

Such quotes serve to highlight Brooks’ point: Those who have tackled the subject often comically reveal their own limits, the limits of their own thinking and experience, and of their chosen mediums. Brooks should know, as he does have a penchant for trying to paint big, somewhat cultural, political, and sociological pictures of American life. Yet, as Schama in particular demonstrates, there are some things he does very well despite his assumptions. In fact, I think he and others are as much trying to address the assumptions and opinions of their own people as much as their subject.

“As a philosopher, if I were speaking to a purely philosophic audience I should say that I ought to describe myself as an Agnostic, because I do not think that there is a conclusive argument by which one can prove that there is not a God.

On the other hand, if I am to convey the right impression to the ordinary man in the street I think I ought to say that I am an Atheist, because when I say that I cannot prove that there is not a God, I ought to add equally that I cannot prove that there are not the Homeric gods.”